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Background. Healthcare organizations have been challenged to be more efficient and productive, and at the same time, mental health indicators for medical staff are alarming. Health policy needs to improve the experience of providing care, not only by limiting burnout, but also by enabling medical staff to find meaning and pleasure in their work. The self-determination theory assumes that individuals simultaneously endorse several types of motivation, which constitutes a person's motivational profile. While self-determined motivation is positively related to individual well-being, controlled motivation is more related to indicators of ill-being, such as burnout. Social environments such as hospitals are encouraged to promote self-determined behavior through the satisfaction of psychological needs (competence, autonomy, relatedness). To apply self-determination theory to the field of hospital organization, we developed the Medical Staff Motivation Inventory (MSMI) to assess the degree of importance (motivational profile) and satisfaction of hospital-specific motivators. Methods. An item pool was developed to inventory motivators, reasons for going to work, covering psychological needs, for hospital medical staff. The importance of a motivator represents the personal meaning attributed to an activity, whereas the satisfaction of a motivator (motivational satisfaction) reflects the joy associated with the feeling of success and fulfilment. The survey was administered via email to 1,399 staff at two hospitals from November 2020 to January 2021. A principal component analysis (PCA) of the importance score detailed the dimensions grouping the motivators. A composite satisfaction score overall and for each component was calculated by weighting the satisfaction value of each motivator by the importance value of the motivator. For convergent validity, we correlated the satisfaction scores with the three dimensions of the Maslach Burnout Inventory (MBI). Results. A sample of 367 medical staff from two hospitals completed the online survey. PCA on the importance of the 21 motivators indicated a 4-component structure with 19 motivators, explaining 45% of the variance: quality teamwork, professional autonomy, institutional agility, recognition. Motivational satisfaction composite scores were negatively related to the MBI dimensions of "emotional exhaustion" and "depersonalization", and positively related to the dimension of "personal fulfillment". Each respondent can obtain his/her own motivational profile and motivational satisfaction, with the aim of improving the quality of work life. The graphs and scores at different granularities of an organization offer a diagnosis of motivational profiles and proposals for improving motivational satisfaction for managers of healthcare organizations. Conclusion. The MSMI is a tool for answering "How can we improve the experience of providing care by caregivers?" It could be a measure of the impact of healthcare organizations, policies, and procedures on the stress and quality of work life of hospital medical staff. ; Contexte. Les organisations de santé ont été mises au défi d'être plus efficaces et productives et, dans le même temps, les indicateurs de santé mentale du personnel médical sont alarmants. La politique de santé doit améliorer l'expérience de la prestation de soins, en limitant l'épuisement professionnel, mais aussi en permettant au personnel médical de trouver du sens et du plaisir au travail. La théorie de l'autodétermination suppose que les individus endossent simultanément plusieurs types de motivation, ce qui constitue le profil motivationnel d'une personne. Alors que la motivation autodéterminée est liée positivement au bien-être des individus, la motivation contrôlée est davantage liée à des indicateurs de mal-être, tel que l'épuisement professionnel. Les environnements sociaux tels que les hôpitaux sont encouragés à promouvoir les comportements autodéterminés grâce à la satisfaction des besoins psychologiques (compétence, autonomie, affiliation). Pour appliquer la théorie de l'autodétermination dans le domaine de l'organisation hospitalière, nous avons développé le Medical Staff Motivation Inventory (MSMI) afin d'évaluer le degré d'importance (profil motivationnel) et de satisfaction de motivateurs spécifiques à l'hôpital. Méthodes. Un pool d'items a été développé pour répertorier les motivateurs, les raisons d'aller au travail, couvrant les besoins psychologiques, pour le personnel médical hospitalier. L'importance d'un motivateur représente le sens personnel attribué à une activité, tandis que la satisfaction d'un motivateur (satisfaction motivationnelle) reflète la joie liée au sentiment de réussite et d'accomplissement. L'enquête a été administrée par courriel à 1,399 personnels de deux hôpitaux, de novembre 2020 à janvier 2021. Une analyse en composantes principales (ACP) du score d'importance a détaillé les dimensions regroupant les motivateurs. Un score composite de satisfaction globale et pour chaque composante a été calculé en pondérant la valeur de satisfaction de chaque motivateur par la valeur d'importance du motivateur. Pour la validité convergente, nous avons corrélé les scores de satisfaction avec les trois dimensions du Maslach Burnout Inventory (MBI). Résultats. Un échantillon de 367 personnels médicaux de deux hôpitaux a répondu à l'enquête en ligne. L'ACP sur l'importance des 21 motivateurs a indiqué une structure en 4 composantes sur 19 motivateurs, expliquant 45% de la variance : travail d'équipe de qualité, autonomie professionnelle, agilité institutionnelle, reconnaissance. Les scores composites de satisfaction motivationnelle sont négativement liés aux dimensions "épuisement émotionnel" et "dépersonnalisation" du MBI, et positivement à la dimension "accomplissement personnel". Chacun des répondants peut obtenir son propre profil motivationnel et sa propre satisfaction motivationnelle, dans un objectif d'amélioration de la qualité de vie au travail. Les graphiques et les scores à différentes granularités d'une organisation offrent un diagnostic des profils motivationnels et des propositions d'amélioration de la satisfaction motivationnelle au service des managers des organisations de santé. Conclusion. Le MSMI est un outil permettant de répondre à "Comment améliorer l'expérience de la prestation de soins par les soignants ?". Il pourrait être une mesure de l'impact des organisations, politiques et procédures de santé sur le stress et la qualité de vie au travail du personnel médical hospitalier.

Background. Healthcare organizations have been challenged to be more efficient and productive, and at the same time, mental health indicators for medical staff are alarming. Health policy needs to improve the experience of providing care, not only by limiting burnout, but also by enabling medical staff to find meaning and pleasure in their work. The self-determination theory assumes that individuals simultaneously endorse several types of motivation, which constitutes a person's motivational profile. While self-determined motivation is positively related to individual well-being, controlled motivation is more related to indicators of ill-being, such as burnout. Social environments such as hospitals are encouraged to promote self-determined behavior through the satisfaction of psychological needs (competence, autonomy, relatedness). To apply self-determination theory to the field of hospital organization, we developed the Medical Staff Motivation Inventory (MSMI) to assess the degree of importance (motivational profile) and satisfaction of hospital-specific motivators. Methods. An item pool was developed to inventory motivators, reasons for going to work, covering psychological needs, for hospital medical staff. The importance of a motivator represents the personal meaning attributed to an activity, whereas the satisfaction of a motivator (motivational satisfaction) reflects the joy associated with the feeling of success and fulfilment. The survey was administered via email to 1,399 staff at two hospitals from November 2020 to January 2021. A principal component analysis (PCA) of the importance score detailed the dimensions grouping the motivators. A composite satisfaction score overall and for each component was calculated by weighting the satisfaction value of each motivator by the importance value of the motivator. For convergent validity, we correlated the satisfaction scores with the three dimensions of the Maslach Burnout Inventory (MBI). Results. A sample of 367 medical staff from two hospitals completed the online survey. PCA on the importance of the 21 motivators indicated a 4-component structure with 19 motivators, explaining 45% of the variance: quality teamwork, professional autonomy, institutional agility, recognition. Motivational satisfaction composite scores were negatively related to the MBI dimensions of "emotional exhaustion" and "depersonalization", and positively related to the dimension of "personal fulfillment". Each respondent can obtain his/her own motivational profile and motivational satisfaction, with the aim of improving the quality of work life. The graphs and scores at different granularities of an organization offer a diagnosis of motivational profiles and proposals for improving motivational satisfaction for managers of healthcare organizations. Conclusion. The MSMI is a tool for answering "How can we improve the experience of providing care by caregivers?" It could be a measure of the impact of healthcare organizations, policies, and procedures on the stress and quality of work life of hospital medical staff. ; Contexte. Les organisations de santé ont été mises au défi d'être plus efficaces et productives et, dans le même temps, les indicateurs de santé mentale du personnel médical sont alarmants. La politique de santé doit améliorer l'expérience de la prestation de soins, en limitant l'épuisement professionnel, mais aussi en permettant au personnel médical de trouver du sens et du plaisir au travail. La théorie de l'autodétermination suppose que les individus endossent simultanément plusieurs types de motivation, ce qui constitue le profil motivationnel d'une personne. Alors que la motivation autodéterminée est liée positivement au bien-être des individus, la motivation contrôlée est davantage liée à des indicateurs de mal-être, tel que l'épuisement professionnel. Les environnements sociaux tels que les hôpitaux sont encouragés à promouvoir les comportements autodéterminés grâce à la satisfaction des besoins psychologiques (compétence, autonomie, affiliation). Pour appliquer la théorie de l'autodétermination dans le domaine de l'organisation hospitalière, nous avons développé le Medical Staff Motivation Inventory (MSMI) afin d'évaluer le degré d'importance (profil motivationnel) et de satisfaction de motivateurs spécifiques à l'hôpital. Méthodes. Un pool d'items a été développé pour répertorier les motivateurs, les raisons d'aller au travail, couvrant les besoins psychologiques, pour le personnel médical hospitalier. L'importance d'un motivateur représente le sens personnel attribué à une activité, tandis que la satisfaction d'un motivateur (satisfaction motivationnelle) reflète la joie liée au sentiment de réussite et d'accomplissement. L'enquête a été administrée par courriel à 1,399 personnels de deux hôpitaux, de novembre 2020 à janvier 2021. Une analyse en composantes principales (ACP) du score d'importance a détaillé les dimensions regroupant les motivateurs. Un score composite de satisfaction globale et pour chaque composante a été calculé en pondérant la valeur de satisfaction de chaque motivateur par la valeur d'importance du motivateur. Pour la validité convergente, nous avons corrélé les scores de satisfaction avec les trois dimensions du Maslach Burnout Inventory (MBI). Résultats. Un échantillon de 367 personnels médicaux de deux hôpitaux a répondu à l'enquête en ligne. L'ACP sur l'importance des 21 motivateurs a indiqué une structure en 4 composantes sur 19 motivateurs, expliquant 45% de la variance : travail d'équipe de qualité, autonomie professionnelle, agilité institutionnelle, reconnaissance. Les scores composites de satisfaction motivationnelle sont négativement liés aux dimensions "épuisement émotionnel" et "dépersonnalisation" du MBI, et positivement à la dimension "accomplissement personnel". Chacun des répondants peut obtenir son propre profil motivationnel et sa propre satisfaction motivationnelle, dans un objectif d'amélioration de la qualité de vie au travail. Les graphiques et les scores à différentes granularités d'une organisation offrent un diagnostic des profils motivationnels et des propositions d'amélioration de la satisfaction motivationnelle au service des managers des organisations de santé. Conclusion. Le MSMI est un outil permettant de répondre à "Comment améliorer l'expérience de la prestation de soins par les soignants ?". Il pourrait être une mesure de l'impact des organisations, politiques et procédures de santé sur le stress et la qualité de vie au travail du personnel médical hospitalier.

International audience ; The etiology of central nervous system (CNS) tumors is complex and involves many suspected risk factors. Scientific evidence remains insufficient, in particular in the agricultural field. The goal of our study was to investigate associations between agricultural activities and CNS tumors in the entire French farm manager workforce using data from the TRACTOR project. The TRACTOR project hold a large administrative health database covering the entire French agricultural workforce, over the period 2002-2016, on the whole French metropolitan territory. Associations were estimated for 26 activities and CNS tumors using Cox proportional hazards model, with time to first CNS tumor insurance declaration as the underlying timescale, adjusting for sex, age and geographical area. There were 1017 cases among 1 036 069 farm managers, including 317 meningiomas and 479 gliomas. Associations varied with tumor types, sex and types of crop and animal farming. Analyses showed several increased risks of CNS tumors, in particular for animal farming. The main increases in risk were observed for meningioma in mixed dairy and cow farming (hazard ratio [HR] = 1.75, 95% confidence interval [CI]: 1.09-2.81) and glioma in pig farming (HR = 2.28, 95% CI: 1.37-3.80). Our study brings new insights on the association of a wide range of agricultural activities and CNS tumor and subtype-specific risks in farm managers. Although these findings need to be corroborated in further studies and should be interpreted cautiously, they could have implications for enhancing CNS tumor surveillance in agriculture.

International audience ; The etiology of central nervous system (CNS) tumors is complex and involves many suspected risk factors. Scientific evidence remains insufficient, in particular in the agricultural field. The goal of our study was to investigate associations between agricultural activities and CNS tumors in the entire French farm manager workforce using data from the TRACTOR project. The TRACTOR project hold a large administrative health database covering the entire French agricultural workforce, over the period 2002-2016, on the whole French metropolitan territory. Associations were estimated for 26 activities and CNS tumors using Cox proportional hazards model, with time to first CNS tumor insurance declaration as the underlying timescale, adjusting for sex, age and geographical area. There were 1017 cases among 1 036 069 farm managers, including 317 meningiomas and 479 gliomas. Associations varied with tumor types, sex and types of crop and animal farming. Analyses showed several increased risks of CNS tumors, in particular for animal farming. The main increases in risk were observed for meningioma in mixed dairy and cow farming (hazard ratio [HR] = 1.75, 95% confidence interval [CI]: 1.09-2.81) and glioma in pig farming (HR = 2.28, 95% CI: 1.37-3.80). Our study brings new insights on the association of a wide range of agricultural activities and CNS tumor and subtype-specific risks in farm managers. Although these findings need to be corroborated in further studies and should be interpreted cautiously, they could have implications for enhancing CNS tumor surveillance in agriculture.

International audience ; The etiology of central nervous system (CNS) tumors is complex and involves many suspected risk factors. Scientific evidence remains insufficient, in particular in the agricultural field. The goal of our study was to investigate associations between agricultural activities and CNS tumors in the entire French farm manager workforce using data from the TRACTOR project. The TRACTOR project hold a large administrative health database covering the entire French agricultural workforce, over the period 2002-2016, on the whole French metropolitan territory. Associations were estimated for 26 activities and CNS tumors using Cox proportional hazards model, with time to first CNS tumor insurance declaration as the underlying timescale, adjusting for sex, age and geographical area. There were 1017 cases among 1 036 069 farm managers, including 317 meningiomas and 479 gliomas. Associations varied with tumor types, sex and types of crop and animal farming. Analyses showed several increased risks of CNS tumors, in particular for animal farming. The main increases in risk were observed for meningioma in mixed dairy and cow farming (hazard ratio [HR] = 1.75, 95% confidence interval [CI]: 1.09-2.81) and glioma in pig farming (HR = 2.28, 95% CI: 1.37-3.80). Our study brings new insights on the association of a wide range of agricultural activities and CNS tumor and subtype-specific risks in farm managers. Although these findings need to be corroborated in further studies and should be interpreted cautiously, they could have implications for enhancing CNS tumor surveillance in agriculture.